Inspection Detail

Inspection: 306002338 - Lj Shaw Company Independent Insurance Adjusters

Inspection Information - Office: Chicago South Area Office

Inspection Nr: 306002338

Report ID: 0521700

Date Opened: 11/12/2003

Site Address:
Lj Shaw Company Independent Insurance Adjusters
1100 South Main Street
Lombard, IL 60148

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:6411

NAICS: 524291/Claims Adjusting

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 11/12/2003

Emphasis: L:Fall, S:Construction Fatalities

Case Closed: 11/12/2003

Related Activity
Type	Activity Nr	Safety	Health
Accident	100031905

Investigation Summary

Investigation Nr: 200032019

Event: 11/11/2003

Employee killed in fall from ladder

On November 11, 2003, Employee #1, a claim adjuster, was onsite at a claimant's property in St. Harvey, IL, investigating a report of a burglary, which occurred at the facility. Employee #1 was thought to have completed his investigation, but instead took a ladder from his car and climbed up the rear roof of the facility. As he was descending the ladder, he fell. Employee #1 was transferred to a nearby hospital where he later died.

Keywords: ROOF, LADDER, FALL, CONCUSSION, WORK SURFACE

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	306002338			Fatality	Concussion	Insurance adjusters, examiners and investigators

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